Abstract
BackgroundBetter understanding of the trends and disparities in health at old age in terms of life expectancy will help to provide appropriate responses to the growing needs of health and social care for the older population in the context of limited resources. As a result of rapid economic, demographic and epidemiological changes, the number of people aged 60 and over in Vietnam is increasing rapidly, from 6.7% in 1979 to 9.2% in 2006. Life expectancy at birth has increased but not much are known about changes in old ages. This study assesses the trends and socioeconomic inequalities in RLE at age 60 in a rural area in an effort to highlight this vulnerable group and to anticipate their future health and social needs.MethodsAn abridged life table adjusted for small area data was used to estimate cohort life expectancies at old age and the corresponding 95% confidence intervals from longitudinal data collected by FilaBavi DSS during 1999-2006, which covered 7,668 people at age 60+ with 43,272 person-years, out of a total of 64,053 people with 388,278 person-years. Differences in life expectancy were examined according to socioeconomic factors, including socio-demographic characteristics, wealth, poverty and living arrangements.ResultsLife expectancies at age 60 have increased by approximately one year from the period 1999-2002 to 2003-2006. The increases are observed in both sexes, but are significant among females and relate to improvements among those who belong to the middle and upper household wealth quintiles. However, life expectancy tends to decrease in the most vulnerable groups. There is a wide gap in life expectancy according to poverty status and living arrangements, and the gap by poverty status has widened over the study period. The gender gap in life expectancy is consistent across all socioeconomic groups and tends to be wider amongst the more disadvantaged population.ConclusionsThere is a trend of increasing life expectancy among older people in rural areas of Vietnam. Inequalities in life expectancy exist between socioeconomic groups, especially between different poverty levels and also patterns of living arrangements. These inequalities should be addressed by appropriate social and health policies with stronger targeting of the poorest and most disadvantaged groups.
Highlights
Better understanding of the trends and disparities in health at old age in terms of life expectancy will help to provide appropriate responses to the growing needs of health and social care for the older population in the context of limited resources
The current study provides additional evidence on Vietnam's exceptional population health, which might be partially explained by the appropriateness of the current health system that has remaining life expectancy (RLE) 95%CI RLE 95%CI
The present study shows that RLE is significantly higher in better economic groups, classified by thresholds of per capita income or expenditure according to the national or international poverty lines
Summary
Better understanding of the trends and disparities in health at old age in terms of life expectancy will help to provide appropriate responses to the growing needs of health and social care for the older population in the context of limited resources. Inequality in income increased temporary migration from the rural to urban areas because of better employment opportunities [5]. This movement of young people and other impacts of the country's economic transition may have a negative effect by weakening the traditional family structure and leaving more older people to live on their own with less physical and emotional support from family members [8]. On one hand older men are losing the benefits of living in an extended household where they receive more emotional and physical support from the women of the household, but on the other hand older women may benefit as there are fewer expectations and demands for them to do house work and nurture the family in a less extended family
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